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EVAN PAUL PROVISOR MD
NPI 1366427429
Surgery in Southbridge, MA

Active since December 13, 2005PECOS Enrolled
97.02/100
CMS Quality Rating
94 SOUTH ST, SOUTHBRIDGE, MA 01550(508) 764-6966(508) 764-2457 Get Directions Write a Review

NPPES record last updated: December 21, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Evan Paul Provisor Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVAN PAUL PROVISOR MD (NPI 1366427429) is an individual surgery provider in Southbridge, Massachusetts, licensed in Massachusetts (237945) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366427429
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameEVAN PAUL PROVISORCredential: MD
Location Address94 SOUTH STSouthbridge, MA 01550-4000
Mailing Address94 South StSouthbridge, MA 01550-4000 · (508) 764-6966 · Fax (508) 764-2457
Phone(508) 764-6966
Fax(508) 764-2457
Sole ProprietorNo
Enumeration DateDecember 13, 2005
Last NPPES UpdateDecember 21, 2011
✔ NPI 1366427429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MA · 237945
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
94 SOUTH ST, Southbridge, MA 01550
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Other Identifiers 4

Medicare PIN000741604MA
Medicare PIN000741601MA
Medicaid2160307MA
Medicare UPINB37903

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evan Paul Provisor Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Evan Provisor reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Umass Memorial Health-Harrington Hospital Inc
Same address
General Acute Care Hospital
100 SOUTH STREET
Southbridge, MA 01550
  • Reassigned Medicare billing, Massachusetts enrollment
  • 68 clinicians in this Medicare group
NPI 1790780047 (508) 765-9771

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01550 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHEN T HILBORN MD
Surgery
94 SOUTH ST, HARRINGTON PHYSICIAN SERVICES
SOUTHBRIDGE, MA 01550
Worcester County (508) 764-2772
LISA GAY SCHNARE C.S.F.A.
Specialist/Technologist, Other (Surgical Assistant)
94 SOUTH ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 764-2772
KONSTANTINO A AVRADOPOULOS MD
Surgery
94 SOUTH ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 764-6966
DR. CHARLES A SOMMER MD
Orthopaedic Surgery
94 SOUTH ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 764-2772
YOUNG-HO OH M.D.
Orthopaedic Surgery
94 SOUTH ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 764-2772
SAMANTHA M CHASE MD
Orthopaedic Surgery
94 SOUTH ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 764-2772
DR. HARRY WATKEY EASTERLY III MD
Surgery
94 SOUTH ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 764-6966
SARAH J DAIGLE DPM
Podiatrist
94 SOUTH ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 764-2772

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evan Provisor's NPI number?

The NPI number for Evan Provisor is 1366427429. It was assigned to this individual provider in the NPPES registry on December 13, 2005.

Where is Evan Provisor located?

Evan Provisor practices at 94 South St, Southbridge, MA 01550. The listed phone number is (508) 764-6966.

What is Evan Provisor's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Evan Provisor enrolled in Medicare?

Yes. Evan Provisor is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Evan Provisor's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Evan Provisor reassigns Medicare benefits to Umass Memorial Health-Harrington Hospital Inc (Southbridge, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Evan Provisor's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Evan Provisor was last updated on December 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.